© 1996 Oxford University Press
research-article |
Health Effects of Human T-Lymphotropic Virus Type I (HTLV-I) in a Jamaican Cohort
*Departments of Laboratory Medicine, Medicine, and Epidemiology & Biostatistics, University of California San Francisco Box 0884, San Francisco, CA 94143, USA.
**Tropical Medicine Research Unit and the Departments of Pathology and Medicine, University of the West Indies Kingston/St Andrew, Jamaica.
Ministry of Health Kingston/St Andrew, Jamaica.
Research Triangle Institute Washington DC, USA.
National Cancer Institute Bethesda, MD, USA.
Murphy E L (Departments of Laboratory Medicine, Medicine and Epidemiology and Biostatisties, University of California, San Francisco Box 0884, San Francisco, CA 94143, USA), Wilks R, Morgan O St C, Hanchard B, Cranston B, Figueroa J P, Gibbs W N, Murphy J and Blattner W A. Health effects of human T-lymphotropic virus type I (HTLV-I) in a Jamaican cohort. International Journal of Epidemiology 1996; 25: 1090–1097.
BACKGROUND: Other than adult T-cell leukaemia (ATL) and HTLV-l associated myelopathy (HAM), the health effects of infection with human T-lymphotropic virus type I (HTLV-I) are not well defined.
METHOD: A cohort of 201 confirmed HTLV-I seropositive Jamaican food service workers and 225 seronegative controls of similar age and sex from the same population was examined. A health questionnaire, physical examination, and laboratory tests were performed at enrolment into the cohort in 1987–1988.
RESULTS: One of 201 HTLV-I seropositives, but no controls were diagnosed with HAM, for a prevalence of 0.5% (95% confidence interval) (Cl) 0.01–2.7%); no cases of ATL were diagnosed. While there was no difference in current symptoms, the HTLV-I seropositive group was more likely to report a past medical history of hepatitis or Jaundice (OR = 3.49, 95% Cl : 0.93–13.08), malaria (OR = 2.13, 95% Cl: 0.96–4.73), and dengue fever (OR = 1.37, 95% Cl : 0.82–2.29); however, these differences were of borderline statistical significance. Low income HTLV-I seropositive women had lower body weight (P < 0.01) and body mass index (P < 0.009) than their seronegative counterparts; similar differences were seen in the smaller male group. A trend toward higher prevalence of severe anaemia (haemoglobin <10 g/dl) (12.6% versus 7.7%, P < 0.105) and a significantly lower prevalence of eosinophilia (1.0% versus 6.3%, P < 0.004) was seen among HTLV-I seropositives compared to controls.
CONCLUSIONS: Although most HTLV-I seropositives are asymptomatic, HAM may be diagnosed in approximately 0.5% of carriers. Chronic HTLV-I Infection may also exert subtle effects on body mass and haematological parameters.
Keywords HTLV-I infection, HTLV-I associated myelopathy, tropical spastic paraparesis, anaemia, eosinophilia, body mass index
Revised 1 February 1996
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